title: Prior oral antithrombotic therapy is associated with early death in patients with supratentorial intracerebral hemorrhage.
abstract: OBJECTIVE
  Although oral antithrombotic therapy (OAT) is a risk factor of intracerebral hemorrhage (ICH), the clinical course of supratentorial ICH with prior OAT is unclear. We therefore assessed the characteristics of supratentorial ICH with OAT to determine whether OAT is independently associated with early death in supratentorial ICH.
  
  
  METHODS
  We retrospectively enrolled consecutive patients with supratentorial ICH admitted to the Stroke Center of Kawasaki Medical School Hospital within 24 hours of onset, from April 2004 to March 2009. The group with OAT therapy (OA group) was compared with the group without (non-OA group).
  
  
  RESULTS
  A total of 389 patients with supratentorial ICH (median age 68 years, 61% males) were enrolled in the present study. OAT was used in 24% of patients. The OA group was older than the non-OA group (median 74 vs. 66 years, p<0.001). In the OA group, Glasgow Coma Scale was less (10 vs. 13, p<0.001), and hematomas were larger (22 mL vs. 14 mL, p<0.001). Early death was more frequently observed in the OA group than in the non-OA group (28% vs. 8.1%, p<0.001). Unadjusted HR of OAT for death within 14 days was 3.62 (95% CI: 2.06-6.33, p<0.001), the age- and sex-adjusted HR was 3.84 (95% CI: 2.12-6.96, p<0.001), and HR adjusted for age, sex, GCS, and hematoma volume was 2.01 (95% CI: 1.11-3.65, p=0.022). HR adjusted for age, sex, GCS, and hematoma volume at day 1 was 2.63 (p=0.34), day 3: 2.35 (p=0.03), day 7: 2.01 (p=0.04), and day 14: 1.90 (p=0.04).
  
  
  CONCLUSIONS
  The OA group patients were older, their GCS was lower, they had larger hematoma volume, and more frequent occurrence of early death. Prior oral antithrombotic therapy is associated with early death in patients with supratentorial ICH.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Japan. shinji-yamashita@umin.net
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamashita
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000401:mortality*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin